FACTORS INFLUENCING EMBEDDING OF ORGANISATION-WIDE CULTURE CHANGE PROGRAMS IN HEALTHCARE – A Scoping Review

 

Introduction

Organisation wide culture change programs (OWCCP) have been used as a mechanism to assist staff to provide safe patient care and improve patient and staff outcomes. There is, however, considerable variability in effectively sustaining outcomes at an organisation, facility or service level. Understanding factors that enable the embedding of OWCCP and how they do so can help achieve the quadruple aim.

Embedding is the period between implementing and sustaining, where the initiatives or interventions within the change program (TYE) become a part of the every-day work practices or routines of individuals and workgroups (1).  The aim of the study was to examine what and how factors influence embedding of OWCC in health care.

 

Method

A scoping literature review, conducted in 2021, across nine databases identified 19,793 records. A review of the records assessed that 15 studies met the research criteria. Data was then extracted from the 15 studies using SQUIRE 2.0 guidelines and thematic analysis was conducted.

 

Results

There were ten key factors identified as influencing the ability to embed OWCCP in healthcare (Refer to Image 1).  These 10 key factors appeared consistently across the 15 studies reviewed.

 

Conclusion

Embedding of OWCCP is achieved by a dynamic interwoven interplay of multiple factors. There are organisational, strategic, engagement, resourcing, and change initiative factors simultaneously engaged. While identified their impact individually and collectively, their combination or order to achieve and embed change remains obscured. A critical problem is a lack of definition or explanation about what “embedding” entails preventing comparable evaluations of studies. To progress understanding further research is needed into how different factors influence embedding of OWCCP and how these factors are influenced by differing populations, settings, systems, and processes.

 

Reference

1. Goodridge, D., Rana, M., Harrison, E., Rotter, T., Dobson, R., Groot, G., Lloyd, J. (2018). Assessing the implementation processes of a large-scale multi-year quality improvement initiative; survey of health care providers. BMC Health Serv Res. 18(1) 1-22.